Mangaki amasonto? Ngenye yemibuzo yokuqala abantu ababuza mayelana namawele nama-multiples. Ukungcoliswa kokuqala kungengozi ukuthi iningi lezinxephezelo libhekane, futhi imiphumela yokuzalwa kwasekuqaleni ihlukahluka kancane kancane ibe isongela ukuphila. UMashi weDeses ulinganisela ukuthi amawele angaphezu kuka-50%, amaphesenti angama-90 wezintathu futhi cishe wonke ama-quadruplethi neziphindaphindiwe ze-oda eziphakeme zizalwa ngaphambi kwesikhathi, noma ngaphambi kweviki lama-37 lokukhulelwa.
Ekuqaleni ukuzalwa, ingozi enkulu yezinkinga ezinganeni.
Nakuba ukuthuthuka kwezobuchwepheshe bezokwelapha kuye kwathuthukisa kakhulu umbono wezingane ezingakabiphi, inani lokubeletha ngaphambi kwesikhathi liye lenyuka, okwenza ukuguqulwa kokuqala kungabangela imbangela yokufa kwezinsana kanye necala lokuholela kokufa kwabantwana abangaphansi kweminyaka emihlanu. Emhlabeni wonke, eyodwa kwezingane ezishumi emhlabeni wonke izalwa ngaphambi kwesikhathi.
Imiphumela Yokuzalwa Kwangaphambi Kokuqala
Ngenxa yobungozi obandayo, kubalulekile ukuthi abazali bephindaphindiwe baqonde umthelela ongase ubambelele ekubhekaneni nezingane. Ukuguqulwa kokuqala kuyothinta impilo yemindeni ngezinga elihlukile. Kwabanye, kungase kusho isikhashana esibhedlela. Kodwa abanye bakhuthazelela ukuhlala esibhedlela ngemuva kokuba izingane zabo zifike. Kwezinye izimo, izinkinga zezokwelapha kanye nezindaba ziyisici kuphela emasontweni ambalwa okuqala ngemva kokuzalwa, kanti ezinye izimo zinezimo zomhlaba wonke.
Isici esinqumayo ngokuvamile siyisikhathi sokuzalwa. Amantombazane azalwa eduze nosuku lwawo olulinganiselwe bancane amathuba okuba nezinkinga ezinkulu ngoba izitho zabo ziye zaba nesikhathi esengeziwe sokukhula esibelethweni.
Ukukhathazeka Ngokudokotela Okusheshayo
Isibeletho sisebenza njengendawo ephelele yabantwana ukuthuthukisa. Lapho abantwana bezalwa kakhulu kusenesikhathi, izitho zabo zivulekile futhi azilungele ukusebenza "ezweni elingaphandle." Ukuguqulwa kwe-prematurity kuthinta zonke izitho ezibalulekile emzimbeni.
- Imifula: Abantwana, ikakhulukazi labo abazalwa ngaphambi kwamasonto angu-34, banenkinga yokuphefumula emoyeni. I-respiratory depression syndrome ingaphathwa ngokusizwa okuphefumulayo kanye nomuntu osebenzelana nokuphefumula, into esiza amaphaphu amancane anganda. Ngezinye izikhathi izinyathelo zokulondoloza impilo ezisetshenziselwa ukwelapha amaphutha emaphashini zibangelwa isifo samaphaphu esingapheli noma i-bronchopulmonary dysplasia (BPD) futhi singadinga ukwelashwa okuqhubekayo.
- Ubuchopho: Ukushisa kwegazi (IVH) okwenzeka esikhathini esizayo ebuchosheni obuthinta kakhulu abantwana abazalwa ngaphambi kwamasonto angama-32 noma abantwana abaye babhekana nokucindezeleka kwesinye isimo sokuqeda isimo sokuqala, njengokucindezeleka kokuphefumula. Kungabangela umonakalo ebuchosheni noma kwehla umsele wamanzi omgogodla oholela ekwakheni kwamanzi amaningi futhi azungeze ubuchopho (i-hydrocephalus).
- Inhliziyo: Esibelethweni, i-ductus arteriosus ivumela izinsana ukuthi zithole umoya-mpilo ngokusebenzisa intambo, ngokudlula amaphaphu. Ekuzalweni, lesi sitsha segazi kufanele sivale. Izingane ezisengaphambi kokuqala zingathuthukisa i-Patent Ductus Arteriosus, ebangela ukugeleza kwegazi okungavamile phakathi kwemithambo emikhulu yegazi ezungeze inhliziyo. Kungabangela ukuhluleka kwenhliziyo.
- Amathumbu: Ukujwayele ukuthola ukondla kusuka e-placenta nge-cord umbilical, izinhlelo zokubeletha ezinganeni zingakakulungeli ukucubungula ukudla. Izingane ezisanda kuzalwa zingathuthuka ukuvuvukala kwebhande lamathumbu noma izifo ezinzima kakhulu. I-entocolitis neecrotizing (NEC) ingabangela ukutheleleka okusakazekile noma ukulimala kwamathumbu noma indawo yokufa okungaholela ekuvinjeni futhi kungadinga ukuhlinzwa ukulungisa.
- Amehlo: Iningi lezingane ezisengaphambi kwesikhathi zakha izinkinga ngamehlo abo ngoba imithwalo yegazi ye-retina ayitholakali ngokuphelele. Ukutakula kabusha kwe-Prematurity (ROP) imiphumela lapho ukuthuthukiswa kwemithambo yegazi ephazamisekile kuphazamiseka kokuzala ngaphambi kwesikhathi bese uyeka ukukhula noma ukukhula ngokungavamile. Amacala amakhulu angabangela ukukhubazeka kombono noma ubumpumputhe. Ngezinye izikhathi isimo singaphathwa ngokushesha ngokuhlinzwa noma ukwelashwa kwe-laser, futhi amacala amaningi azozixazulula ngokwabo ngokuhamba kwesikhathi.
Lezi zimo zimelela "izimo ezimbi kunazo zonke" ezibhekene nezinsana ezingakafiki ngaphambi kwesikhathi, ezelwe ngaphambi kwamasonto angu-32 ukubeletha.
Ezimweni eziningi, ukuphindaphindiwe okungakapheli kokuthola usizo lwezokwelapha ezakhiweni zesibhedlela zanamuhla kuyakwazi ukunqoba izinselele zokuqala kwazo.
Ukukhathazeka Kwezokwelapha Okuqhubekayo
Ngemuva kwesigaba sokuqala esibucayi emva kokuzalwa kokuqala, lapho kugxile ekusindeni, imiphumela ye-prematurity kungenzeka ingaziwa ngokugcwele. Ezinye zezinkinga zesikhathi eside zingase zingabonakali kuze kube yilapho izimpande ziqala isikole. Kungaba yinkinga kubazali, abasebevele becindezelwe yinselelo yokunakekela izingane ezingaphezu kweyodwa.
Ucwaningo lwezokwelapha lwango-2008 lwaluvuselele ama-alamu ngezinkinga ezandisiwe zezitha ngesikhathi sokuphila kwazo. Abacwaningi abavela eDuke University Medical Centre balandela izingane ezingaphezu kwezigidi ezizalwa eNorway kusukela ngo-1967-1988. Baphetha ngokuthi izinsana zangaphambi kwesikhathi ziyizi:
- Kungenzeka ukuthi bafe ngesikhathi besencane
- Kungenakwenzeka ukuthi babe nezingane zabo njengabantu abadala
- Kubonakala kungenasiphelo sokuqeda isikole esiphakeme noma ekolishi ephelele
Abacwaningi bathi lezi ziphumo ezinkingeni zezokwelapha ezibangelwa kusengaphambili kanye nesimo sezenhlalakahle esinciphisa ngenxa yezimo zezokwelapha. Kodwa-ke, idatha yabo ayifaki amawele noma ama-multiples, futhi abantu abasesifundweni bazalwa eminyakeni engaphezu kwengu-20 eyedlule futhi bebengenakufinyelela kwezobuchwepheshe bezokwelapha ezisiza izingane eziningi ezingakabiphi namuhla. Kubalulekile ukugcina lolu cwaningo ngendlela efanele.
Okuyiqiniso ukuthi ezinye izimpande ezingakapheli zizokhula nokukhubazeka okuhlala njalo, kusukela ekuphusheni kwengqondo kuya ekuphefumuleni kwengqondo kuya embonweni noma ekulahlekelweni kokuzwa. Abanye bangase bathole ukubambezeleka kokuthuthukiswa, izinkinga zokufunda esikoleni noma ukulahlekelwa ukunakwa. Abanye bangase bafune nje izibuko noma bahlushwa yi-allergies noma i-asthma. Izimo eziningi zinganqotshwa izinhlelo zokungenelela zakuqala ezibandakanya ukwelashwa ngokomzimba, inkulumo noma imisebenzi. Ezinye izinkinga zingalungiswa ngokuhlinzwa. Futhi inqwaba yezimpande ezingakapheli zizohola izimpilo ngaphandle kwemiphumela engekho kusukela ekuthomeni kwabo kwasekuqaleni empilweni.
Ayikho indlela yokubikezela imiphumela ngayinye. Akekho udokotela ophethe i-crystal ball ukubikezela ukuthi umntwana okhulelwe uyokhula yini enempilo. Kodwa abazali bangasiza ekuqinisekiseni imiphumela emihle yezimpande zabo ngokuqaphela izinkinga ezingase zibe khona kanye nokubambisana nabanakekeli bezokwelapha zabantwana babo ukuqapha ukuthuthukiswa kwabo futhi bathole usizo uma kudingeka.
Umthombo:
Loftin, R., et al. "Ukuzalwa Kwangaphambi Kokuqala." Ukubuyekeza ku-Obstetrics and Gynecology , Winter 2010, k. 10.
Swamy, G., et al. "Inhlangano Yokuzalwa Ngaphambi Kokuzalwa Okusinda Kwesikhathi Eside, Ukukhiqiza, Nokuzalwa Okuqala Kwangaphambi Kokuzalwa," I- Journal of the American Medical Association, ngo- Mashi 26, 2008, k. 1429.
"Ukukhulelwa ngamawele, kathathu kanye nezinye iziphindaphindi." March of Dimes Foundation. Kufinyelelwe ngoJanuwari 12, 2016. http://www.marchofdimes.org/multiples-twins-triplets-and-beyond.aspx
"Wazalwa Ngokushesha: I-Global Action Report Yokuzalwa Kwangaphambi Kokuzalwa." March of Dimes Foundation. Kufinyelelwe ngoJanuwari 12, 2016. http://www.marchofdimes.org/materials/born-too-soon-global-action-report-on-preterm-birth.pdf